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Features of the UK childcare environment and associations with preschooler's in-care physical activity.

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Hesketh, Kathryn R 
van Sluijs, Esther MF 


OBJECTIVE: Features of the childcare environment may influence children's in-care physical activity (PA). We assessed the association between UK preschool care-provider, environmental and policy factors and 3-4-year-olds' average daily in-care sedentary behaviour (SED) and PA. METHODS: In 2013, we used accelerometers to measure the in-care SED/ PA of 201 3-4-year-old children (51% female) in 30 preschools in Cambridgeshire, UK, (average wear time: (mean ± SD) 4.2 ± 1.3 week-days). We assessed the childcare environment using the Environment and Policy Assessment and Observation tool; demographic and carer information was taken from questionnaires. We used three-level mixed-effects regression analyses (adjusted for sex, in-care time and travel mode to care) to determine the association between childcare factors and children's in-care average daily minutes/hour spent SED, in light PA (LPA) and in moderate-to-vigorous PA (MVPA). RESULTS: Children spent 5.6 ± 2.5 h in care per day on average; clustering of PA within preschools was limited (ICCs: 0.003-0.05). Fully adjusted models showed that active opportunities were positively associated with children's in-care SED. No associations with in-care LPA and MVPA were observed. CONCLUSION: Few care-provider, environmental and policy factors were associated with children's in-care activity. UK childcare policies advocating child-driven play, moving freely indoors and outdoors, may be more conducive to individual children's PA.



Childcare, EPAO, Environment Policy Assessment and Observation, Environment, ICC, Intra-class correlation co-efficient, IMD, Index of Multiple Deprivation, LPA, Light physical activity, MVPA, Moderate-to-vigorous physical activity, Ofsted, Office for Standards in Education, PA, Physical activity, Physical activity, Policy, Preschool-aged children, SED, Sedentary, SPACE, Studying Physical Activity in preschool-aged Children and their Environment Study, Sedentary

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Elsevier BV
Medical Research Council (MC_UU_12015/7)
Medical Research Council (MR/K023187/1)
Economic and Social Research Council (ES/G007462/1)
Wellcome Trust (087636/Z/08/Z)
We thank all children and their parents who participated in the SPACE study. In addition, we thank Kate Westgate and Stefanie Mayle from the physical activity technical team at the MRC Epidemiology Unit for their assistance in processing the accelerometer data, and members of the field team who conducted data collection. This work was conducted by the Medical Research Council [Unit Programme numbers MC_UU_12015/7; MC_UU_12015/4] and the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research, and Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged (CEDAR grant number: RES-590-28-0002). No financial disclosures were reported by the authors of this paper.